Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
Curr Opin Psychiatry. 2019 May;32(3):248-253. doi: 10.1097/YCO.0000000000000496.
To synthesize recent knowledge on the association of urbanization (and neighbourhood factors) and anxiety and stress-related disorders.
The quality of urban neighbourhoods and neighbourhood factors - physical (e.g. green space), social (e.g. social cohesion) and biological (e.g. stress response) factors - are directly linked to the presence and severity of anxiety disorders, although data on posttraumatic stress disorder (PTSD) are pauce. Preliminary data indicate that architectural and space design elements in PTSD can either increase anxiety and lead to trauma triggers or relieve symptoms and reinforce safety. In addition, there is emerging evidence that being raised in urban environments with a wide range of microbial exposure dampens the immune response to psychosocial stressors.
Evidence points to a higher prevalence of anxiety disorders and PTSD in urban environments. Current research is focused on the role of neighbourhood factors in prevention and treatment. Few studies have assessed comprehensive treatment models in urban populations and the potential moderating role of these factors on treatment outcomes. Several lines of inquiry are starting to address how urban living impacts on biological stress regulation pathways. As urbanization continues, improved understanding of urban mental health is central to informing mental health promotion policies.
综合近期有关城市化（及其邻里因素）与焦虑和应激相关障碍关联的知识。
城市邻里环境及其邻里因素的质量——物质（如绿色空间）、社会（如社会凝聚力）和生物（如应激反应）因素——与焦虑障碍的存在和严重程度直接相关，尽管有关创伤后应激障碍（PTSD）的数据很少。初步数据表明，PTSD 中的建筑和空间设计元素要么会增加焦虑并引发创伤，要么会缓解症状并增强安全感。此外，有新的证据表明，在微生物暴露范围广泛的城市环境中成长会抑制对心理社会应激源的免疫反应。
有证据表明，焦虑障碍和 PTSD 在城市环境中的发病率更高。目前的研究重点是邻里因素在预防和治疗中的作用。很少有研究评估过针对城市人群的综合治疗模式，以及这些因素对治疗效果的潜在调节作用。一些研究方向开始探讨城市生活如何影响生物应激调节途径。随着城市化的继续，更好地了解城市心理健康对于为心理健康促进政策提供信息至关重要。
